New Law Caps Out Of Pocket Costs For Essential Medications In NJ
February has unique meanings for different people, from Black History Month to President's Day Weekend to Valentine's Day. But for some New Jersey residents, this month has been a long time coming because of chronic and pre-existing medical conditions.
Last Summer, New Jersey Governor Phil Murphy signed NJ Legislative Bill S1614 which caps the out-of-pocket costs for Insulin, EpiPens, and Asthma Inhalers. The new law also requires Health Insurance Carries to provide at least one epinephrine auto-injector device without deductible or co-payment required if prescribed by a doctor or hospital.
The new law that goes into effect starting February 1, 2024 has the following caps to out-of-pocket costs for these essential medications:
*Insulin is capped at $35 per months supply and most Medical Insurance plans will not be allowed to charge a deductible or co-payment a month's supply. Also Health Insurance Carries must pay for any blood glocuse test strips, insulin pumps, injection aids, syringes, and infusion decisions if used by a hospital or prescribled by a health care provider.
*EpiPens will be capped at $25 for a month's supply and will not be be subject to copayment or deductible under most Healh Insurance Plans. Also, Hospitals and Health Care Providers are not allowed to require a co-payment for prescribing an Epinephrine Auto-Injector Device.
*Asthma Inhalers are to be capped at $50 for a month's supply and the coverage for the prescription should not require a deductible or co-payment. As long as the Asthma Medication is prescribed by a Helath Care Prodiver, most Medical Insurance Companies will be required to cover the costs beyond the out-of-pocket cap.
This is a important news for many people who depend on these medications to live a normal life and without them they could be Clinically Disabled or would die without the administration of these essential prescriptions. For many years, Health Care Providers and Medical Insurance Companies have attempted to force people who need Insulin or EpiPens or Asthma Inhalers to pay above market prices for life essential medications.